Case 4: Running on Empty Flashcards

1
Q

What can hyperpigmentation be caused by? (3)

A

pregnancy, UV exposure, Addison’s Disease

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2
Q

What is p53? What does it do and what can it trigger?

A

Guardian of the Genome
senses DNA and cell health
can suspend proliferation for repair
DNA damage = p53 triggers apoptosis

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3
Q

In response to UV damage, what does p53 do? What does this substance cleave in to?

A

activation of gene which encodes POMC which cleaves into melanin stimulating hormone (MSH)

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4
Q

What does MSH stimulate?

A

stimulates melancortin 1 receptors

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5
Q

What do melancortin 1 receptors trigger?

A

production of 2nd messenger (cAMP)

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6
Q

What does cAMP do?

A

increases transcription of gene for melanin, therefore melanin pigment is produced

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7
Q

Once produced, where is melanin transferred from and to, why and how?

A

from melanocytes to keratinocytes
protect nuclei from DNA damage
via melanosomes

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8
Q

What are the layers of the medulla, cortex (3) and capsule?

A
adrenal medulla
zona reticularis 
zona fasciculata
zona glomerulosa
capsule
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9
Q

What hormones are secreted from the medulla?

A

catecholamines (eg. adrenaline and noradrenaline)

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10
Q

What hormones are secreted from the zona reticularis?

A

sex hormones (eg. DHEA)

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11
Q

What hormones are secreted from the zona fasciculate?

A

glucocorticoids (eg. cortisol)

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12
Q

What hormones are secreted from the zona glomerulosa?

A

mineralcorticoids (eg. aldosterone)

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13
Q

Peptides: cell receptor site, signaling, soluble, half life, derived?

A
surface
2nd messenger
water
mins
amino acids
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14
Q

Steroids: cell receptor site, signaling, soluble, half life, derived?

A
intra
activates genes
lipid
days
cholesterol
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15
Q

Thyroid hormones: cell receptor site, signaling, soluble, half life, derived?

A
intra
activates genes
lipid
days
iodinated tyrosine
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16
Q

Catecholamines: cell receptor site, signaling, soluble, half life, derived?

A
surface
2nd messengers
water
mins
tyrosine
17
Q

What are the three categories of adrenal steroids?

A

glucocorticoids
mineralcorticoids
sex steroids

18
Q

What is cortisol? What does it do?

A

glucocorticoid
anti-insulin
decreases glucose uptake
permissive for the actions of catecholamines
vasoconstriction (decrease synthesis of NO)
increases bone reabsorption

19
Q

What is cortisol useful for treating?

A

allergies
autoimmune
transplants

20
Q

What are cortisol levels regulated by?

A
stress
diurnal rhythm (high in morning due to anti-insulin properties)
21
Q

What does ADH do?

A

conserves water
vasoconstriction
increase calcium influx

22
Q

What triggers aldosterone release?

A

low BP and volume

23
Q

What does aldosterone trigger?

A

increases renin secretion (which then increases angiotensin II which is RAAS system)
increased reabsorption of salt and water

24
Q

Where are sex hormones secreted from? What are they regulated by?

A

zona reticularis

regulated by ACTH

25
What is a primary endocrine dysfunction?
problem with gland
26
What is a secondary endocrine dysfunction?
problem with under or over secretion of gland from higher pathway
27
What is a primary adrenocortical deficiency due to?
Addison's disease | undersecretion
28
What is a secondary adrenocortical deficiency due to?
hypothalamic-pituitary disease | suppression of HPA axis due to chronically elevated steroid levels
29
What tests can be used to diagnose Addison's disease? (4)
Cortisol level test (low) Auto-antibodies test (adrenal antibodies) Fasting glucose test (low) ACTH stimulating test (minimal change after 30 mins)
30
What is an aldosterone deficiency due to?
zona glomerulosa not stimulated
31
What is an Addison's crisis triggered by and what is treatment?
stress injection of hydrocortisone IV fluids